Why Providers Love Engaged Patients: Q&A With Phyllis Gilmore, MD

When a patient engages with their provider, health coach, or clinic, everyone wins. Why? Because engaging is the first step for a patient to take ownership of their own health. But it's not just a winning moment for the patient, it's also a major turning point for providers who derive significant benefits from patients who want to work to improve their own health.

To take a look at the win-win scenario of patient engagement, we chatted with Vera provider Dr. Phyllis Gilmore in downtown Portland, OR. Here's what she had to say.

Q: What are the hallmarks of an engaged patient? How can you tell they’re making a serious investment in their health?

Phyllis: Number one, I’d say, is diligence in coming to appointments. Number two, of course, would be adherence with medication. Number three would be asking questions about not only the disease process, but the treatment.

Q: If someone isn’t particularly engaged, how do you approach getting them more invested in their own health?

Phyllis: I always start with learning about the patient. I think we too often come at a patient with our evidence-based approach to medicine. We dive directly in. We don’t ask what this diagnosis means for their life. This is their disease, so we need to deal with their understanding, objectives, and questions.

Two Truths About Patient Engagement

In this study, we looked at 4,118 participating patients at Seattle Children's over the course of six years. 46% of these patients used the Vera on-site clinic. The remaining 54% did not.

Q: Are unengaged patients ever self-motivated to increase their engagement? What steps do you take with patients to increase their motivation?

Phyllis: Often, I think behavior change is jump-started by a person’s environment or family. Maybe their neighbor died or their aunt didn’t get a mammogram and was diagnosed with cancer too late. Some precipitating event in their life has caused them to decide to make a change. The one thing I don’t use is fear tactics. I don’t believe in saying to someone, "If you don’t do this, you’re going to lose your leg." Fear tactics aren’t appropriate. Instead, I ask them what I can do to help them.

Phyllis: The very first step for a person to become engaged is to acknowledge that they care about themselves and that their health is important to them and their family. Does it automatically make numbers on the chart better? I’m not really sure. But I also think that we’re in a stage of medicine where we use numbers as a benchmark too much, rather than how the patient feels. Outcomes aren’t just numbers, they’re how we feel about being alive.

"Outcomes aren’t just numbers, they’re how we feel about being alive."

Q:How does Vera’s model allow you to engage more deeply with patients?

Phyllis: It allows time to talk to patients. If I have time, I’m engaged as well. If I’m engaged, I want to go in there and get to know the patient as a person. You can't do that in 15 minutes. I have time to get to know this person, find out what their hindrances are, where their motivation might be. The encouragement I get from my employer is just for that. They’re not looking at my production at the end of the day. Vera is looking to be able to cross a barrier and change a health culture and ultimately change a health status, or a company’s health status, and they recognize that I need time with a patient to do that.

Q: If you could tell non-engaged patients to make one proactive investment in their health what would it be?

Phyllis: To take a piece of paper and draw a line down the middle. Imagine yourself in 10 years and on the left side of the paper, write the things that you want to be or that you want to do in 10 years as a healthy person. On the other side, write down all the things that you won’t be able to be or do if you’re not a healthy person in 10 years.

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